Evidence-led articles
Where would you like to start?
Evidence-led writing about managing gout — anchored to the treatment guidelines rather than to food lists. Choose the explanation that fits where you are now.
Newly diagnosed
A calm place to begin.
Start with the number your doctor is watching, then move to the questions a high result raises and what to know before the next flare.
Start here
Uric acid target for gout: the number that actually matters
Most gout advice is about food. The guidelines are about a number: your serum urate level, and whether it is under the treatment target.
Read this firstHow gout works
See what is happening underneath.
The snow-on-a-roof picture gives the numbers and the flares a shape: crystals can build, break loose, and slowly clear as urate comes down.
The complete journal
All published articles.
9 pieces
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Your uric acid number 6 min read
What your gout snow picture meansThe four snow-on-a-roof pictures show whether urate crystals are probably building, shedding, melting or gone, and what may happen next.
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Water 6 min read
Does drinking water help gout? An honest answerThe gout guidelines contain 42 recommendations and not one is about drinking water. Here is what the evidence does and does not support.
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Food and diet 8 min read
Gout is not a punishment for what you ateDiet explains under 1% of the variation in people's uric acid levels. Genetics explains about 24%. Here is what actually sets your number.
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Your uric acid number 6 min read
A high uric acid result, but no symptomsYour blood test flagged a high urate level and nothing hurts. The guidelines recommend against treating it, and against ignoring it. Both, for good reasons.
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Your uric acid number 3 min read
Uric acid target for gout: the number that actually mattersMost gout advice is about food. The guidelines are about a number: your serum urate level, and whether it is under the treatment target.
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Medication 6 min read
Why people stop taking allopurinol for gout, and what helpsGout has the worst medication adherence of any common chronic disease, worse than diabetes, blood pressure or cholesterol. The reasons are structural.
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Flares 6 min read
What the guidelines say to do when a flare startsThree first-line flare treatments, ranked equal. Low-dose colchicine over high-dose. And the one thing not to do: stop your daily tablet.
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Medication 6 min read
Uric acid still high on allopurinol? Check the doseAllopurinol is meant to start low and then be increased until your uric acid is under target. For a lot of people, the second half never happens.
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Medication 6 min read
Why gout flares can get worse after starting allopurinolStarting treatment often brings more attacks, not fewer. A snow-on-a-roof analogy from a rheumatology journal explains why, and why it passes.